Wiki 90792

[moriatti]

Is it acceptable practice to bill just the technical portion of a service (such as 90792 psychiatric diagnostic evaluation with medical services) and suppress (not bill) the professional portion of that service? When the service is provided by a non-credentialed or ineligible provider of that service, is it acceptable to just suppress the professional component and collect for the technical component?

 

[Robyn07]

Is it acceptable practice to bill just the technical portion of a service (such as 90792 psychiatric diagnostic evaluation with medical services) and suppress (not bill) the professional portion of that service? When the service is provided by a non-credentialed or ineligible provider of that service, is it acceptable to just suppress the professional component and collect for the technical component?

This service is a provider service and there is no "Technical Component" to this code.

 

[mitchellde]

Correct you cannot split a professional only service such as an evaluation, it has no technical component. If it was known prior to the patient encounter that this was an ineligible provider then the service should not have been provided, or the patient need to be informed of the status and given the option to pay or have it treated as an out of network provider. If the patient was not informed of the provider's status, I do not think you can bill it as out of network either.